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Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome SARS-CoV-2 Infection
JAMA (Journal of the American Medical Association) ^ | April 24, 2020 | Mayla Gabriela Silva Borba, MD et al

Posted on 04/24/2020 1:14:42 PM PDT by ProtectOurFreedom

A Randomized Clinical Trial

KEY POINTS

Question How safe and effective are 2 different regimens of chloroquine diphosphate in the treatment of severe coronavirus disease 2019 (COVID-19)?

Findings In this phase IIb randomized clinical trial of 81 patients with COVID-19, an unplanned interim analysis recommended by an independent data safety and monitoring board found that a higher dosage of chloroquine diphosphate for 10 days was associated with more toxic effects and lethality, particularly affecting QTc interval prolongation. The limited sample size did not allow the study to show any benefit overall regarding treatment efficacy.

Meaning The preliminary findings from the CloroCovid-19 trial suggest that higher dosage of chloroquine should not be recommended for the treatment of severe COVID-19, especially among patients also receiving azithromycin and oseltamivir, because of safety concerns regarding QTc interval prolongation and increased lethality.

ABSTRACT

Importance There is no specific antiviral therapy recommended for coronavirus disease 2019 (COVID-19). In vitro studies indicate that the antiviral effect of chloroquine diphosphate (CQ) requires a high concentration of the drug.

Main Outcomes and Measures Primary outcome was reduction in lethality by at least 50% in the high-dosage group compared with the low-dosage group. Data presented here refer primarily to safety and lethality outcomes during treatment on day 13. Secondary end points included participant clinical status, laboratory examinations, and electrocardiogram results. Outcomes will be presented to day 28. Viral respiratory secretion RNA detection was performed on days 0 and 4.

(Excerpt) Read more at jamanetwork.com ...


TOPICS: Culture/Society; Government; News/Current Events
KEYWORDS: covid19; hcq; hydrochloroquine; trial
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Objective To evaluate the safety and efficacy of 2 CQ dosages in patients with severe COVID-19.

Design, Setting, and Participants This parallel, double-masked, randomized, phase IIb clinical trial with 81 adult patients who were hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was conducted from March 23 to April 5, 2020, at a tertiary care facility in Manaus, Brazilian Amazon.

Interventions Patients were allocated to receive high-dosage CQ (ie, 600 mg CQ twice daily for 10 days) or low-dosage CQ (ie, 450 mg twice daily on day 1 and once daily for 4 days).

Results Out of a predefined sample size of 440 patients, 81 were enrolled (41 [50.6%] to high-dosage group and 40 [49.4%] to low-dosage group). Enrolled patients had a mean (SD) age of 51.1 (13.9) years, and most (60 [75.3%]) were men. Older age (mean [SD] age, 54.7 [13.7] years vs 47.4 [13.3] years) and more heart disease (5 of 28 [17.9%] vs 0) were seen in the high-dose group. Viral RNA was detected in 31 of 40 (77.5%) and 31 of 41 (75.6%) patients in the low-dosage and high-dosage groups, respectively. Lethality until day 13 was 39.0% in the high-dosage group (16 of 41) and 15.0% in the low-dosage group (6 of 40). The high-dosage group presented more instance of QTc interval greater than 500 milliseconds (7 of 37 [18.9%]) compared with the low-dosage group (4 of 36 [11.1%]). Respiratory secretion at day 4 was negative in only 6 of 27 patients (22.2%).

Conclusions and Relevance The preliminary findings of this study suggest that the higher CQ dosage should not be recommended for critically ill patients with COVID-19 because of its potential safety hazards, especially when taken concurrently with azithromycin and oseltamivir. These findings cannot be extrapolated to patients with nonsevere COVID-19.


This is the study upon which the FDA made its recommendation to not use HCQ outside hospitals or clinical trials. I find several points interesting:
1 posted on 04/24/2020 1:14:42 PM PDT by ProtectOurFreedom
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To: ProtectOurFreedom

Thanks for pointing out/posting the absurdity of this JAMA CQ study.

They didn’t even use the recommended protocol - as suggested by Dr Z and others.

They did NOT use HCQ or Zinc.

So, out the window their silly study goes.


2 posted on 04/24/2020 1:18:03 PM PDT by Jane Long (Praise God, from whom ALL blessings flow.)
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To: ProtectOurFreedom

If its good enough for my goldfish....


3 posted on 04/24/2020 1:18:50 PM PDT by Pearls Before Swine
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To: ProtectOurFreedom

bump


4 posted on 04/24/2020 1:21:08 PM PDT by Bob434
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To: ProtectOurFreedom

When will someone scream it to the heavens - it is NOT the HCQ causing cardiac incidents. It is the Z-PAK which has always been known to cause QT problems. it is NOT hcq, it is the ZPAK - and many doctors with cardiac COVID patients simply substitute doxycycline, which has ALWAYS been comparable to ZPAK.

Sorry about the caps - I was fighting the urge to caplock ongoing.

$$$ quote from the article: “...reduction in lethality by at least 50% in the high-dosage group compared with the low-dosage group”


5 posted on 04/24/2020 1:24:20 PM PDT by true believer forever (Fight the Attacks against Trump: PLANT YOUR FEET, LEAN INTO IT, BEAT IT BACK.)
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To: Jane Long

and they are testing THE WRONG DRUG!!!!


6 posted on 04/24/2020 1:24:36 PM PDT by faucetman (Just the facts, ma'am, Just the facts)
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To: faucetman

I know...that’s what I said.

They used CQ, not HCQ.


7 posted on 04/24/2020 1:26:24 PM PDT by Jane Long (Praise God, from whom ALL blessings flow.)
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To: faucetman

HYDROXYcloroquine,

HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY, HYDROXY


8 posted on 04/24/2020 1:26:53 PM PDT by faucetman (Just the facts, ma'am, Just the facts)
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To: ProtectOurFreedom

Paul Sperry
@paulsperry_

If chloroquine’s so “dangerous” & even “poisonous,” why has the CDC for years been advising this:”Both adults and children should take one dose of chloroquine per week starting at least 1 week before traveling to the area where malaria transmission occurs”

https://www.cdc.gov/malaria/resources/pdf/fsp/drugs/chloroquine.pdf

That is a nice color brochure with some interesting details.


9 posted on 04/24/2020 1:27:09 PM PDT by Revel
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To: Jane Long

Sorry, meant to post to 1


10 posted on 04/24/2020 1:28:50 PM PDT by faucetman (Just the facts, ma'am, Just the facts)
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To: ProtectOurFreedom

The AMA has long been a leftist organization with a political agenda. In this case, they have committed scientific and medical malpractice by not being honest about HCQ. If the damn stuff is so bad, which lupus or malaria patients will they notify to take them off their medication?


11 posted on 04/24/2020 1:30:38 PM PDT by Chauncey Gardiner
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To: faucetman

And, per Dr Z....

ZINC, ZINC, ZINC, ZINC, ZINC. ZINC, ZINC, ZINC, ZINC, ZINC, ZINC....


12 posted on 04/24/2020 1:31:00 PM PDT by Jane Long (Praise God, from whom ALL blessings flow.)
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To: ProtectOurFreedom
You and bramps need to go away. Every time you post anything, you are working to denigrate the President and/or poo poo the use of HYDROXYCHOLOQUINE.

You probably have no idea that choloquine diphosphate and hydroxychloroquine are very different drusg with very different side effect profiles. You are the enemy of the good. Sadly, you are too spiritually dead to see the blood accumulating on your hands.

BTW, agitprop, where is the zinc side of the efficacy scale?

13 posted on 04/24/2020 1:34:55 PM PDT by MHGinTN (A dispensation perspective is a powerful tool for discernment)
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To: ProtectOurFreedom

14 posted on 04/24/2020 1:35:33 PM PDT by JonPreston
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To: ProtectOurFreedom

Science has been politicized.

Ultimately that actually may kill us.


15 posted on 04/24/2020 1:35:50 PM PDT by Buckeye McFrog (Patrick Henry would have been an anti-vaxxer)
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To: true believer forever

“It is the Z-PAK which has always been known to cause QT problems. it is NOT hcq, it is the ZPAK - and many doctors with cardiac COVID patients simply substitute doxycycline, which has ALWAYS been comparable to ZPAK.”

Very interesting. I had HORRIBLE bronchitis the first quarter of 2019. Went through three different antibiotics including a Z-Pak and doxycycline (different times) plus steroids and an inhaler. Took full 12 weeks to get rid of it. I was unaware of possible cardiac complications with azithromycin.


16 posted on 04/24/2020 1:37:05 PM PDT by ProtectOurFreedom
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To: ProtectOurFreedom

I don’t see in the results where they actually tested a combination of CQ and azithromycin, just CQ... and once again not Hydroxychloriquine. Another bogus test.


17 posted on 04/24/2020 1:38:00 PM PDT by dhuls (better late than never)
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To: MHGinTN

What the HELL are you talking about??? I posted this to show the FLAWS in the study that the FDA is using TODAY to denigrate the HCQ / Az / Zinc protocol. Didn’t you read ANYTHING I wrote?

Every other reader understood what I was saying.

Sheesh.


18 posted on 04/24/2020 1:39:37 PM PDT by ProtectOurFreedom
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To: ProtectOurFreedom

“Main Outcomes and Measures Primary outcome was reduction in lethality by at least 50% in the high-dosage group compared with the low-dosage group”

I think what this means is that a reduction of 50% in lethality would have been support for using high dose chloroquine.

That is not what happened, however. 39% of the high dose group died, 15% of the low dose group. The high dose group was older. They all had severe disease and the drug was chloroquine not hydroxychloroquine.


19 posted on 04/24/2020 1:41:24 PM PDT by heartwood (Someone has to play devil's advocate.)
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To: dhuls

Yes.

PLUS, they used Tamiflu in conjunction with CQ and azithromycin, but no Zinc.

Perhaps others have tested antivirals in conjunction with HCQ / CQ and azithromycin, but that’s the first I’ve heard of it.


20 posted on 04/24/2020 1:41:26 PM PDT by ProtectOurFreedom
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